A 38-year-old man presented with a black pigmented patch overlying his upper lip, a part of the gingiva and the hard palate. An intradermal tumor mass was palpated at the central portion of the pigmented patch of the upper lip. Diphenylcyclopropenone (DPCP) is a potent contact sensitizer that could stimulate non-specific immunity. We report a case of desmoplastic malignant melanoma (DMM) in which an atypical lentiginous pigmentation disappeared with topical DPCP immunotherapy and the dermal tumor mass was removed by a surgical wedge-shaped excision. Though an atypical lentiginous pigmentation of DMM sometimes undergoes extensive spontaneous regression, in our case it could be attributed to the therapeutic effect of topical DPCP immunotherapy rather than a spontaneous regression.
Adult ; Gingiva ; Humans ; Immunity, Innate ; Immunotherapy ; Lip ; Melanoma* ; Palate, Hard ; Pigmentation*

Psoriasis is a relatively common disorder that affects at least 1-2% of the population, however, the pathogenesis is not fully understood yet. Histopathologically, psoriatic lesion is characterized by hyperplasia of keratinocyte, intraepidermal neutrophil accumulation and activated T lymphocyte infiltration in the dermis. Among many cytokines, IL-8 is known to play a role for the activation and migration for neutrophil and T lymphocyte and for the proliferation of keratinocyte. We performed immunohistochemical staining with anti-IL-8 monoclonal antibody for the active lesion, stable lesion and normal-looking skin of ten psoriatic patients and ten healthy controls. Strong expression of IL-8 in the epidermis and dermis was noted from the active as well as stable psoriatic skins. In the normal-looking skin of the psoriatic patients, only faint expression which is not different from healthy control skin, was noted. These observations indicate that the expression of IL-8 is increased in psoriatic lesion, and IL-S is important for the initiation and maintenance of psoriasis.
Cytokines ; Dermis ; Epidermis ; Humans ; Hyperplasia ; Interleukin-8* ; Keratinocytes ; Lymphocytes ; Neutrophils ; Psoriasis ; Skin*

Trichilemmal horn(trichilemmal keratosis) is a rare keratinizing tumor that resembles a cutaneous horn. Histologically, it is characterized by an abrupt maturation of keratinocytes into lamellar keratin without the formation of a granular layer. We describe a case of a trichilemmal horn on the right cheek of a 78-year-old woman.
Aged ; Animals ; Cheek ; Female ; Horns* ; Humans ; Keratinocytes

No abstract available.
Cardiac Tamponade* ; Leukemia, Myeloid, Acute*

This is a report of 2-cases of mandibular prognathism corrected by Intraoral oblique splitting osteotomy of mandibular rami. The Intraoral oblique splitting osteotomy is a modification of sagittal split osteotomy of ramus and it is documented by Yoshida, on 1985. By this method, authors obtained the following results. 1. The patients' esthetic, psychological and functional problems were dissolved by setback of mandibular prognathism. 2. The postoperative infection splitted bone segments fracture, paresthesia of the face and T.M.J. dysfunction were not appeared. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. The patients could open their mouths in normal range after a week of intermaxillary fixation removal. 4. The soft tissue changes of lower lip and chin were about 1:1 to the hard tissue changes. 5. During intermaxillary fixation period and postoperative orthodontic treatment, slight relapse was observed. Now, the patients are under postoperative orthodontic treatment.
Chin ; Humans ; Lip ; Methods ; Mouth ; Osteotomy* ; Paresthesia ; Prognathism* ; Recurrence ; Reference Values

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Epithelium ; Female ; Humans ; Mucous Membrane ; Papilloma* ; Vulva* ; Young Adult

We report an exceptional case of a de novo giant fusiform aneurysm of the basilar trunk, which developed shortly after the therapeutic occlusion of the right internal carotid artery for a fusiform carotid aneurysm. It would appear to be appropriate to call this entity a sequential giant fusiform aneurysm. The patient was successfully treated with endovascular occlusion of the giant basilar trunk aneurysm following bypass surgery.
Adult ; Carotid Artery Diseases/therapy ; Carotid Artery, Internal ; Cerebral Angiography ; Female ; Humans ; Intracranial Aneurysm/diagnosis/*surgery ; Magnetic Resonance Imaging

STUDY DESIGNS: A retrospective study of clinical experience. OBJECTIVES: To investigate and report the iatrogenic form of spinal infections that occur after injection therapy in the spine. SUMMARY OF LITERATURE REVIEW: An iatrogenic infection after injection therapy in the spine is rarely reported to be a serious complication. However, an increase in the number of immunocompromised patients, the aging of the population, and particularly an increase in spinal procedureshave precipitated a rise in the incidence of spinal infections. MATERIALS AND METHOD: Iatrogenic spinal infections occurred in 8 patients after various injection therapy in the spine, which included an epidural steroid injection or trigger point injection for various spinal conditions. The medical records and images of these patients regarding the clinical findings, risk factors, and treatments were analyzed. RESULTS: The pathologic conditions of the spinal infection were discitis in four patients with a concomitant infection in the epidural space and paraspinal muscles, an epidural abscess, and solitary muscular abscess or myositis in the other 3 patients. The systemic risk factors contributing to the infections were diabetes mellitus, metastatic cancer, and chronic liver disease in four patients. For treatment, intensive antibiotic therapy was applied to all patients. Six of the 8 patients underwent surgical drainage for abscesses and/or fusion to stabilize the infected segments. The infections were eventually controlled in all patients. CONCLUSION: Iatrogenic pyogenic infections of the spine after injection therapy in the spine is a serious complication with regard morbidity and treatment. To avoid these serious complications, a specialist experienced in aseptic techniques should perform these spinal procedures, particularly in those patients with the risk factors.
Abscess ; Aging ; Diabetes Mellitus ; Discitis ; Drainage ; Epidural Abscess ; Epidural Space ; Humans ; Immunocompromised Host ; Incidence ; Liver Diseases ; Medical Records ; Myositis ; Paraspinal Muscles ; Retrospective Studies ; Risk Factors ; Specialization ; Spine* ; Trigger Points

PURPOSE: To evaluate the results and complications of treatment using T-plate fixation for two- and three-part fractures of the proximal humerus. MATERIALS AND METHODS: Between January 1996 and July 2003, thirty-three patients with two-part and three-part fractures of the proximal humerus were treated by T-plate fixation. There were 21 two-part fractures and 12 three-part fractures including three shoulder dislocations. The reduction was qualified and complications were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. RESULTS: Thirty-two cases (96.7%) were united, twenty-nine cases (87.9%) were reduced as good, and twenty-three cases (70%) had excellent or satisfactory results. There were four cases of loss of reduction, three cases of stiff joint, one case of nonunion, and one case of avascular necrosis of the humeral head, but no infection. No correlation was found between the final result and the type of fracture, age, gender, or quality of reduction. CONCLUSION: T-plate fixation for proximal humeral fractures is a reliable method to obtain good results through satisfactory reduction, rigid fixation, and early movement. Additional tension band wiring can provide stable fixation for osteoporotic or comminuted fractures difficult to obtain stable fixation.
Fractures, Comminuted ; Humans ; Humeral Head ; Humerus* ; Joints ; Necrosis ; Shoulder Dislocation ; Shoulder Fractures

PURPOSE: To evaluate the results of surgical treatment of posterior wall fractures of the acetabulum and to determine the factors affecting the results. MATERIALS AND METHODS: Thirty-one posterior wall fractures were reviewed; 7 type A1-1, 19 type A1-2 and 5 type A1-3 by AO classification. Postoperatively, the accuracy of the reduction was evaluated. At the final follow-up, clinical and radiographic results were evaluated with medical records and radiographs. The factors affecting the results were determined. RESULTS: The reduction was graded as anatomical in 22 patients, imperfect in seven and poor in two. The clinical result was excellent in 21 hips, good in six, fair in three and poor in one. The quality of the reduction was strongly associated with the clinical result. The radiographic result was excellent in 22 hips, good in five, fair in two and poor in two. The clinical result was related closely to the radiographic result. Complications were osteoarthritis in three patients, osteonecrosis of the femoral head in one, heterotopic ossification in one, penetration of a screw into the joint in one and iatrogenic sciatic nerve injury in one. The factors affecting the clinical results were fracture patterns, the surgeon's experience, the accuracy of the reduction and late complications. CONCLUSION: In this present series of posterior wall fractures, as their prognosis depends on the severity of the injury and the accuracy of the reduction, satisfactory result can be obtained by anatomical reduction with thorough preoperative planning and the surgeon's experience.
Acetabulum* ; Classification ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Medical Records ; Ossification, Heterotopic ; Osteoarthritis ; Osteonecrosis ; Prognosis ; Sciatic Nerve